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Intrathoracic Hernia after Total Gastrectomy
Yoshihiko Tashiro1, Masahiko Murakami1, Koji Otsuka1
1Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan.
Case Reports in Gastroenterology
|July 13, 2016
Summary
Intrathoracic hernias are a rare complication after total gastrectomy. This case highlights the importance of recognizing and promptly treating these hernias to prevent serious outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Thoracic Surgery
Background:
- A 78-year-old male with a history of alcoholic liver cirrhosis underwent total gastrectomy with antecolic Roux-Y reconstruction for early gastric cancer in the remnant stomach.
- Previous laparoscopic proximal gastrectomy was performed 3 years prior; positive surgical margins necessitated the current total gastrectomy.
Observation:
- The patient developed symptoms suggestive of intrathoracic hernia two days post-operation, confirmed by chest X-rays and computed tomography.
- Imaging revealed incarceration of the transverse colon and Roux limb within the left thoracic cavity.
Findings:
- Emergency reduction and surgical repair of the intrathoracic hernia were performed.
- The hernia involved the Roux limb and transverse colon, with the diaphragmatic defect repaired using sutures.
Implications:
- This case underscores the potential for rare but severe complications like intrathoracic hernia following complex gastric surgery.
- Prompt diagnosis and surgical intervention are crucial for managing intrathoracic hernias post-gastrectomy.
- Post-operative complications, including anastomotic leakage and pyothorax, require careful management and prolonged recovery.
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